137. Deputy Barry Ward asked the Minister for Health the options available to medical card holders over the age of 18 who require orthodontic treatment but cannot afford private care; and whether she will outline plans to address unmet orthodontic needs among adults in the public health system; and if she will make a statement on the matter. [51540/26]

199. Deputy Peter 'Chap' Cleere asked the Minister for Health her plans to tackle the waiting list for orthodontist care for children now not being seen throughout primary school; and if she will make a statement on the matter. [48000/26]

I propose to take Questions Nos. 137 and 199 together.

At present, the HSE Oral Healthcare Service aims to provide an oral examination and necessary treatment for children at up to three intervals, targeting ages approximating to second and sixth class and, in some cases, fourth class. Emergency care is provided for children of all ages up to 16. Orthodontic treatment is offered to those who have the greatest level of need and have been assessed and referred for treatment before their 16th birthday. If a child is determined to be grade 4 or grade 5 on the modified IOTN index, they will be placed on a waiting list and offered treatment through the HSE, regardless if they are over the age of 16 when treatment begins.

There are challenges in the provision of dental services, including for children, and patients are waiting longer than they should have to, to access care. The Government has invested €20 million between 2022 and 2025 to support access to children’s orthodontic treatment. This funding has seen the creation of a new initiative supporting access to jaw surgery for orthodontic patients and the transfer of over 5500 patients into private, community-based orthodontic treatment. A further €2.85m is being invested this year to continue these successful orthodontic treatment waiting list initiatives and enable children to access orthodontic care.

Service users may also avail of private healthcare services at any time. However, the HSE is not able to reimburse patients once they have begun treatment privately. Patients or parents who pay for dental services from a private practitioner may claim tax relief for non-routine dental treatment such as orthodontics via Revenue's Med2 Scheme.

I acknowledge that the current system, which was developed in the 1990s in response to the identified oral healthcare needs at that time, needs to be modernised and aligned with current needs.

I am determined to ease the pressure people are facing now in accessing oral healthcare services, including orthodontics. In practical terms, that means improving access to oral healthcare through the public system—especially for children and adult medical card holders. My Department and the HSE are finalising a focused two-year action plan to deliver real improvements on the ground.

The plan will focus on a small number of clear priorities:

• Cut waiting lists in the School Dental Programme and orthodontics

• Strengthen and expand the Special Access Programme

• Reviewing and improving the Dental Treatment Services Scheme

• Support recruitment, education and training

• Support innovation and new ways of delivering care

Over the next two years, the aim is to stabilise services, reduce waiting times, and make access measurably better for patients—while laying the groundwork for longer-term reform.